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2010
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Last modified
11/17/2016 3:11:02 PM
Creation date
11/13/2016 10:16:34 PM
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Box 038
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• BUSINESS CERTIFICATE# bl O/��Q�� <br /> THE COMAVIONWEALTH OF MASSACHUSETTS <br /> TO INV OF MASTIPEE / <br /> DATE <br /> • Expiration Date: <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undersigned hereby declare(s) that a[business under the title of <br /> Business NamcIDBA: mall�hraof�n0.QYKrstdhm Corporation Name: is conducted at <br /> Business Location: 7 S ct va n n a V'S eo 46 M ct —s h <br /> Business i\'IailingAddress: t S a va n n-9 h'S f2t 4 P20-d02-425Z <br /> Business Type: (,-,,TV ST r U 0-4; Oyu Business Telephone: S q VY7 e <br /> Home Phone: ._dg- 2W- 8S_g I Email Address: Mq r-KmU <br /> by the following named persons: <br /> t, Owner Name Owner Residence <br /> MqC ^ Mu)I I 7 5' ✓a nnclh "S hafk <br /> I certify under the penalties of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> taxes as required r.equired under law. <br /> . / <br /> �ignature of authorized agent **Social Security Number(Voluntay) <br /> or Federal Identification Number <br /> *This license will not be issued unless this certification is signed by applicant <br /> In case of emergency <br /> NAME: TELEPHONE NUMBER: <br /> Alarm Company: <br /> **four social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax <br /> payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C, Section 49A. <br /> The Canutonwealth of Massachusetts <br /> BARNSTABLE ss DATE O L d <br /> i <br /> Personally appeared before me the above-named n�L u L�-/ K.I and made oath that the foregoing statement is <br /> true. <br /> A certificate issued in accordance with this section shall be in force and effect for four years from the date of issue and shall be renewed <br /> each four years thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> otary Public <br /> • SEAL n JOSEPHL.MA2�pQHgu <br /> COMIAONW l Ex fres: <br /> UiErTE <br /> MY t ,- <br />
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